On pharmacologically similar to thiazide diuretics . Increases urinary excretion of sodium, chlorine and to a lesser extent of potassium and magnesium ions. With the ability to selectively block the “slow” calcium channels, increases the elasticity of the buy proviron online artery walls and reduces the total peripheral vascular resistance. It helps to reduce hypertrophy of the left ventricle of the heart. No effect on lipid content in the blood plasma (triglycerides, low density lipoprotein, high density lipoprotein); It did not significantly affect the carbohydrate metabolism, but in the presence of hypokalemia can increase blood glucose levels. It has a high volume of distribution, penetrates the blood-tissue barriers (including placental) passes into breast milk. It is metabolized in the liver.In patients with renal insufficiency The pharmacokinetics does not change. Not accumulates.
in the human liver and / or kidney problems, violation of water-electrolyte balance, hyperparathyroidism, patients buy proviron online with an increased QT interval on an electrocardiogram, or concomitant use of drugs prolonging the interval QT, diabetes in decompensation stage, hyperuricemia (especially accompanied by gout and urate nephrolithiasis).
Dosage and administration
The tablets are taken orally without chewing. When hypertension is prescribed 2.5 mg (1 tablet) 1 every day in the morning. With the lack of effectiveness after 4-8 weeks of therapy, it is advisable to add antihypertensive drugs with a different mechanism buy proviron online of action (increase in dosage is inappropriate – in the absence of a significant increase in effect been an increase in side effects).
Side effect On the part of the cardiovascular system – orthostatic hypotension, changes in the electrocardiogram (hypokalemia), arrhythmia, palpitations. From the nervous system – fatigue, nervousness, headache, dizziness, drowsiness, vertigo, insomnia, depression; rarely – fatigue, malaise, muscle spasm, tension, irritability, anxiety. From the digestive system: nausea, vomiting, diarrhea or constipation, decreased appetite, dry mouth, abdominal pain, hepatic encephalopathy (against the background of liver failure) pancreatitis. The respiratory system – coughs, pharyngitis, sinusitis, rarely – rhinitis. From the urinary system – infection, nocturia, polyuria. Allergic reactions – itching, maculopapular rash, urticaria, a hemorrhagic vasculitis. From the side of hematopoiesis: thrombocytopenia , leukopenia, agranulocytosis, bone marrow aplasia, hemolytic anemia Laboratory findings – hyperuricemia, hyperglycemia, hypokalemia, hyposalemia, hyponatremia, hypercalcemia, elevated blood urea nitrogen plasma hypercreatininemia, glycosuria. Other – exacerbation of systemic lupus erythematosus.
Overdosing Symptoms: nausea, vomiting, weakness, impaired function of the gastrointestinal tract, water and electrolyte disturbance, in some cases – an excessive fall in blood pressure, respiratory depression. Patients with cirrhosis may develop hepatic coma. Treatment: gastric lavage, correction fluid and electrolyte balance, symptomatic therapy. No specific antidote.
Interaction with other drugs
Saluretics (loop, thiazide), cardiac glycosides, gluco-and mineralocorticoid, tetrakozaktid, amphotericin B (w / w), laxatives increase the risk of hypokalemia.
When concomitantly with cardiac glycosides increases the likelihood of digitalis intoxication; with calcium supplementation – hypercalcemia; metformin -. possible worsening of lactic acidosis
increases the concentration of lithium ions in the blood plasma (reduced excretion of urine), lithium has nephrotoxic effects.
astemizole, erythromycin (iv), pentamidine, sultopride, terfenadine, vincamine, antiarrhythmics Ia class (quinidine, disopyramide ) and class III (amiodarone, bretylium tosylate, sotalol) may lead to arrhythmia development on type “pirouette” by lengthening of the QT interval.
Non-steroidal anti-inflammatory drugs, glucocorticosteroid buy proviron online agents tetrakozaktid, sympathomimetic reduce the hypotensive effect of baclofen – strengthens.
The combination with potassium-sparing diuretics can be effective for a certain group of patients, however, this is not completely exclude the possibility of the development of hypo- or hyperkalemia, especially in patients with diabetes and renal nedostatochnostyo.
angiotensin-converting enzyme (ACE) inhibitors increase the risk of hypotension and / or acute renal failure (especially when existing renal artery stenosis).
Increases the risk of renal dysfunction when using iodine-containing contrast agents in high doses (dehydration). Before use of iodine-containing contrast media to patients need to restore lost fluids.
Imipraminovye (tricyclic) antidepressants and antipsychotic drugs increase the hypotensive effect and increase the risk of orthostatic hypotension.
Cyclosporin increases the risk of hypercreatininemia.
Reduces the effect of indirect anticoagulants (coumarin derivatives or indandiona) due to increased concentration of clotting factors by reducing the volume of circulating blood and to increase their production by the liver (may require dose adjustment).
Enhances the blockade of neuromuscular transmission, developing under the influence of muscle relaxants nedepolyarizuyuschnh.
Patients taking cardiac glycosides, laxatives, amid hyperaldosteronism, as well as in the elderly shows a regular monitoring of the content of ions of potassium and creatinine.
In patients receiving indapamide should systematically monitor the concentration of ions of potassium, sodium, magnesium in the blood plasma ( may develop electrolyte disturbances), pH, concentration of glucose, uric acid and residual nitrogen.
The most careful control shown in patients with liver cirrhosis (especially with edema or ascites – the risk of metabolic alkalosis, increase the expression of hepatic encephalopathy), ischemic heart disease, congestive heart failure as well as the elderly. The group of high risk include patients with an increased QT interval on the electrocardiogram (congenital or develop on the background of a pathological process).
The first measurement of the concentration of potassium in the blood should be held during the first week of treatment.
Hypercalcemia in patients receiving indapamide may be due to previously diagnosed hyperparathyroidism.
diabetic patients is extremely important to control glucose levels in blood, especially in the presence of hypokalemia.
considerable dehydration may lead to acute renal failure (decreased glomerular filtration). Patients need to compensate for the loss of water and at the beginning of treatment carefully monitor renal function.
Indalamid can give a positive result during the doping control.
In patients with hypertension and hyponatremia (due to diuretics) must be 3 days before you start taking ACE inhibitors stop taking diuretics (for the need for diuretic may be resumed later), or they are assigned initial low doses of ACE inhibitors.
sulfonamide derivative can exacerbate during systemic lupus erythematosus (you must keep in mind the appointment of indapamide).
Effects on ability to drive vehicles and management mechanisms
In the period of treatment must be careful when driving and occupation of other potentially hazardous activities that require high concentration and psychomotor speed reactions.
tablets, film-coated, 2.5 mg.
10 tablets in blisters of PVC film and aluminum foil. 3 blisters with instruction on use in paper cartons.
List B. In dry, dark place at a temperature no higher than 25 ° C. Keep out of the reach of children.
3 years. Do not use after the date printed on the package.
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